The burden of road traffic injuries among patients treated in the largest trauma hospitals in the Republic of Moldova

Abstract

INTRODUCTION Every year, 1.35 million people die in road accidents, with a high mortality rate among young people aged 15-29 years. The problem of road safety is getting worse every year, causing enormous financial damage to healthcare systems and other forms of human suffering, in special in low-middle income countries. Systems for routinely collecting injury data in the Republic of Moldova are limited. OBJECTIVES This study aimed to identify specific characteristics of road traffic injuries among patients treated in the largest trauma hospitals in the country. METHODS It was tested a pilot iCREATE Injury Registry within 2 Emergency Departments in Chisinau municipality. A total number of 7,946 patients with different types of injuries were collected during one year from the existing patient medical records. RedCap was used to upload the data and analyze it through SPSS. RESULTS There have been identified 2,251 road traffic-related cases (28.3% from total), road traffic-specific questions like helmet and child seat in 391 observations (17.4%). Injury cases prevail among men. The most specific age affected by road injury was 19-39 years; the age group >60 years by falls, the age group 8-18 years by school environment injuries. Most cases happened in urban areas (85%). Road traffic victims used proportionally private/public transport in 49% and ground ambulance in 47%. Most cases happened within the road environment and unintentionally (94%), from them due to falls in 63% and 17% due to road traffic event. Among the main purposes in which the persons were mentioned in one of the risk situations of injury were: travel for certain purposes in certain places of personal interest, vital daily activities, unspecified activities, leisure and play, unpaid work, including domestic activities within the home environment. There have been registered 87% cases having a single distinct injury, 2 distinct injuries in 9%. The main types of injury were fracture, contusion, sprain, and concussion/brain injury. Immediate treatment with follow-up was needed in 60% of the cases, a quarter of the injured persons were treated and admitted to the hospital, 8% were treated and released without follow-up. Referring to the road injury event, the seat belt was used in only 34,5% of cases, child safety restraint in 15,1%, and helmet in 15,4%. CONCLUSION The obtained data underline the importance of an injury register, the need to develop health promotion and health education campaigns among the vulnerable groups, and the involvement of all actors in maintaining road safety.